BILL ANALYSIS �
SB 352
Page 1
SENATE THIRD READING
SB 352 (Pavley)
As Amended June 19, 2013
Majority vote
SENATE VOTE :36-2
BUSINESS & PROFESSIONS 10-0
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|Ayes:|Gordon, Jones, Bocanegra, | | |
| |Bonilla, Hagman, Holden, | | |
| |Maienschein, Mullin, | | |
| |Ting, Wilk | | |
|-----+--------------------------+-----+--------------------------|
| | | | |
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SUMMARY : Authorizes medical assistants (MAs) to perform
technical supportive services in any medical setting upon
specific authorization of a physician assistant (PA), nurse
practitioner (NP), or certified nurse-midwife (CNM) without a
physician on the premises. Specifically, this bill :
1)Expands the types of settings where MAs can provide technical
supportive services beyond community and free clinics to any
medical setting, with one exception.
2)Authorizes a physician or surgeon to authorize a NP, CNM, or
PA to supervise MAs following specific written instructions
provided by the physician or surgeon when the supervising
physician or surgeon is not onsite, if either:
a) The NP or CNM is functioning pursuant to standardized
procedures or protocols, including instructions for
specific authorizations, which shall be developed and
approved by the supervising physician and surgeon and the
NP or CNM; or,
b) The PA is functioning pursuant to existing requirements
for supervision and protocols, including instructions for
specific authorizations, and is authorized to do so by the
supervising physician and surgeon.
3)Specifies that the standards applied to MAs will be
SB 352
Page 2
established by the Medical Board of California (MBC).
4)Prohibits the MBC from adopting regulations that violate
existing statutory prohibitions on diagnosis or treatment.
5)Prohibits a MA from performing, or being authorized to
perform, any clinical laboratory test or examination for which
the MA is not authorized under existing law.
6)Prohibits a MA from being employed for inpatient care in a
licensed general acute care hospital.
7)Prohibits a NP, CNM, or PA under this section from being a
laboratory director of a clinical laboratory.
8)Specifies that any authorization provided by a NP, CNM, or PA
for a MA to perform a prohibited procedure would be considered
unprofessional conduct.
FISCAL EFFECT : None. This bill is keyed non-fiscal by the
Legislative Counsel.
COMMENTS :
1)Purpose of this bill . Under existing law, PAs, NPs, and CNMs
are authorized to supervise MAs when the physician is not
physically present, but only in specified licensed community
or free clinics. This bill is intended to promote more
efficient coordinated care by allowing physicians to delegate
the task of MA supervision to PAs, NPs, and CNMs in all
medical settings, except licensed general acute care
hospitals. This bill is sponsored by the California Academy
of Physician Assistants (CAPA).
2)Author's statement . According to the author's office, "One
way to cut down on patient wait-time is to improve to work
distribution in medical offices by allowing MAs to assist in
basic medical tasks under the supervision of a PA, NP, or CNM
in outpatient facilities. MAs already work under these
conditions in free and community clinics. By expanding this
ability to all non-hospital, out-patient facilities, MAs can
better assist other medical staff and promote overall
efficiency."
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3)Medical assistants . MAs are unlicensed medical personnel
trained to perform basic administrative, clerical and
technical supportive services in the office of a physician,
podiatrist or optometrist, and in clinic settings. These
services include taking blood pressure, charting height and
weight, administering medication, performing skin tests, and
withdrawing blood by venipuncture. According to the Bureau of
Labor and Statistics (BLS), in 2011 there were nearly 82,000
MAs employed in California. Nationally, BLS projects this
profession to grow by 34% over 10 years, from 483,600 in 2008,
to 647,500 by 2018.
4)Supervision requirements for MAs . MAs may currently be
supervised by licensed physicians and surgeons, podiatrists,
or optometrists. Before providing any technical services, MAs
must first receive a specific authorization in the form of a
written or standing order prepared by the supervising
physician and surgeon, podiatrist, or optometrist. This order
must specifically authorize the procedures to be performed by
the MA, and the MA must document all services performed in the
patient's record.
When working in a community or free clinic only, MAs may also
be supervised directly by a PA, NP, or CNM, if the supervising
physician or surgeon is not on site and has provided specific
written protocols for the activities the MA is authorized to
perform. With the exception of these clinics, MAs are limited
to performing only administrative and clerical duties when the
physician is not on the premises, and may not perform or
assist with technical supportive services.
Analysis Prepared by : Angela Pontes / B.,P. & C.P. / (916)
319-3301
FN: 0001342